Coverage and benefits

Get a quick overview of your plan benefits and costs, and find more detailed information about additional benefits and programs.

UnitedHealthcare® Group Medicare Advantage (PPO)

2025 materials

National PPO plan overview

  • A national plan covering all eligible beneficiaries regardless of where they reside in the U.S., D.C. and 5 U.S. territories
  • Visit doctors, specialists and hospitals in or out of our network for the same cost share as long as the provider participates in Medicare and accepts the plan
  • Coverage for visiting doctors, clinics and hospitals
  • Routine Vision, hearing, podiatry and chiropractic coverage
  • Routine eyewear and hearing aid allowances
  • No referral needed to see a specialist

Benefits and costs

Plan options and costs
Benefits

UnitedHealthcare® Group Medicare Advantage (PPO)

UnitedHealthcare® Group Medicare Advantage (PPO)
Annual medical deductible

$175 combined for IN and OUT network
Annual medical deductible

$175 combined for IN and OUT network
Annual out-of-pocket maximum

$1,500 (Included $175 deductible) combined for IN and OUT of network
Annual out-of-pocket maximum

$1,500 (Included $175 deductible) combined for IN and OUT of network
Office and clinic visits

$0 copay
Office and clinic visits

$0 copay
Hospital services ( inpatient)

$0 copay
Hospital services ( inpatient)

$0 copay
Hospital services (outpatient)

$0 copay
Hospital services (outpatient)

$0 copay
Emergency care

$50 copayment for each emergency room visit, waived if admitted to inpatient hospital within 24 hours
Emergency care

$50 copayment for each emergency room visit, waived if admitted to inpatient hospital within 24 hours
Emergency care - worldwide

$50 copayment for each emergency room visit
Emergency care - worldwide

$50 copayment for each emergency room visit
Health products benefit

Members receive $60 in credits each quarter ($240 each year) to use on approved health care products as shown in the catalog or website. Credits may be carried over from month to month.
Health products benefit

Members receive $60 in credits each quarter ($240 each year) to use on approved health care products as shown in the catalog or website. Credits may be carried over from month to month.

Preventive services

The following preventive services are covered under your plan for a $0 copay when you visit your primary care provider:

  • Annual Wellness Exam
  • Annual Routine Physical
  • Screenings for certain Cancers (Prostate, colorectal, breast cancer)
  • Screening for diabetes
  • Smoking and Tobacco Use Cessation

For more information about these preventive services, please call the Customer Service number on your UCard.

Disclaimer

Out-of-network/non-contracted providers are under no obligation to treat UnitedHealthcare members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost sharing that applies to out-of-network services.